Guided by Academician Zhang Boli's theory of "dampness， turbidity， phlegm， and fluid-related diseases"，this paper elaborated on the pathogenesis and syndrome differentiation treatment of heart failure from the perspective of the "spleen-mitochondria". It analyzed the essential similarities between "spleen-mitochondria" and "dampness， turbidity， phlegm， and fluid-related diseases"， as well as their close association with the onset of heart failure. Furthermore，it explored the connection between spleen function and mitochondrial function in traditional Chinese medicine （TCM），positing that the spleen's role in transportation and transformation is analogous to mitochondrial material metabolism and energy conversion，with spleen deficiency closely related to mitochondrial dysfunction. It thus concluded that mitochondrial material metabolism and energy conversion represent the microscopic essence of the spleen's role in transportation and transformation，and mitochondrial dysfunction is a contributing factor to pathological products like dampness and turbid phlegm，which are closely associated with the occurrence of heart failure. The four elements of dampness，turbidity，phlegm，and fluid are a series of related symptoms resulting from abnormal fluid transportation and transformation，serving as both factors in the onset of heart failure and the core pathological basis for its deterioration. Therefore，during the treatment of heart failure，it is essential to regulate mitochondrial function. Early intervention should focus on eliminating dampness and turbidity to improve mitochondrial function and restore normal energy metabolism. In the middle and late stages，emphasis should be placed on resolving phlegm，promoting blood circulation，warming Yang，and reducing water retention to alleviate mitochondrial damage and improve cardiac function. Supporting Qi and strengthening the spleen should be a continuous approach，and treatment should be adjusted to enhance mitochondrial function and stabilize the condition，thereby improving prognosis. This paper discussed the role of the spleen and mitochondria in the pathogenesis of heart failure，examined the evolution of heart failure mechanisms from the perspective of dampness， turbidity， phlegm， and fluid-related diseases，and proposed a phased treatment strategy. It enriched the theory of dampness， turbidity， phlegm， and fluid-related diseases and offered new strategies for heart failure treatment. However，in practical application，TCM strategies for treating heart failure need to be integrated with modern medical approaches to provide a more solid scientific foundation for treatment.

Due to the advancement of 16S rRNA sequencing technology, the lower respiratory tract microbiota, which was considered non-existent, has been revealed. The correlation between these microorganisms and diseases such as tumor has been a hot topic in recent years. As the bacteria in the surrounding can infiltrate the tumors, researchers have also begun to pay attention to the biological behavior of tumor bacteria and their interaction with tumors. In this review, we present the characteristic of the lower respiratory tract bacteria and summarize recent research findings on the relationship between these microbiota and lung cancer. On top of that, we also summarize the basic feature of bacteria in tumors and focus on the characteristic of the bacteria in lung cancer. The relationship between bacteria in lung cancer and tumor development is also been discussed. Finally, we review the potential clinical applications of bacterial communities in the lower respiratory tract and lung cancer, and summarize key points of sample collection, sequencing, and contamination control, hoping to provide new ideas for the screening and treatment of tumors.
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Humans ; Lung Neoplasms ; RNA, Ribosomal, 16S/genetics* ; Bacteria/genetics* ; Microbiota ; Respiratory System ; Lung/microbiology*

Objective: To investigate whether melatonin (MT) secretion in different parts of the gastrointestinal tract (GIT) exhibits seasonal variations and its correlation with immune regulation. Methods: Sixty Sprague-Dawley rats were divided into control and model groups, and the pineal gland was removed in the model group. Stomach, jejunum, ileum, and colon tissues were obtained during the spring equinox, summer solstice, beginning of autumn, autumn equinox, and winter solstice. The levels of MT, MT receptors (MR), arylalkylamine N-acetyltransferase (AANAT), hydroxyindole-O-methyltransferase (HIOMT), interleukin-2 (IL-2), and interleukin-10 (IL-10) in the GIT were measured using enzyme-linked immunosorbent assay. Results: Except for the stomach, the jejunum, ileum, and the colon showed seasonal tendencies in MT secretion. In the control group, MT secretion in the jejunum and ileum was the highest in the long summer, and colonic MT secretion was the highest in winter. In the model group, MT levels in the colon were highest in the summer. The seasonal rhythms of the MR, AANAT, HIOMT, IL-2, and IL-10 in the colon were roughly similar to those of MT, and changed accordingly after pinealectomy. Conclusions Gastrointestinal MT secretion is related to seasonal changes, and MT secretion in each intestinal segment is influenced by different seasons. The biological effects of MT in the gut are inextricably linked to the mediation of MR, and a hormone-receptor linkage exists between MT and MR. The effect of seasonal changes on the gastrointestinal immune system may be mediated through the regulation of seasonal secretion of MT.

Neck dissection(ND)is one of the main treatment methods for oral and maxillofacial malignancies.Although ND type is in con-stant improvement,but intraoperative peal-pull-push injury of the accessory nerve,muscle,muscle membrane,fascia and ligament induced shoulder syndrome(SS)is still a common postoperative complication,combined with the influence of radiochemotherapy,not only can cause pain,stiffness,numbness,limited dysfunction of shoulder neck and arm,but also may have serious impact on patient's life quality and phys-ical and mental health.At present,there is still a lack of a systematic evaluation and rehabilitation management program for postoperative SS of oral and maxillofacial malignant tumors.Based on the previous clinical practice and the current available evidence,refer to the relevant lit-erature at home and abroad,the experts in the field of maxillofacial tumor surgery and rehabilitation were invited to discuss,modify and reach a consenusus on the etiology,assessment diagnosis,differential diagnosis,rehabilitation strategy and prevention of SS,in order to provide clinical reference.

In modern medicine,digestive diseases and gynecological diseases belong to different disciplines.From a holistic perspective of TCM,the combination of the two can be collectively referred to as Dai Meridian disease.TCM believes that the basic etiology and pathogenesis of this disease are the obstruction damp heat,the spleen obstruction of cold and dampness,the burning of fire and heat,and the deficiency of essence,qi,and blood causing the deficiency and depression of the meridian.The treatment mainly adopts the method of regulating Dai Meridian,which is a manifestation of the overall differentiation and treatment of TCM,by referring to the Dai Meridian,spleen,stomach,liver,and Thoroughfare Vessel and Conception Vessel.The method of regulating Dai Meridian includes clearing dampness and heat in the meridian,cooling and dampness in the warm meridian,relieving pain in the meridian,and strengthening the meridian deficiency.When treating abdominal symptoms including digestive and gynecological diseases in clinical practice,it is advisable to consider and flexibly apply it,simplify complexity,and with homotherapy for heteropathy.

This article introduced the clinical experience of national famous TCM doctor Professor Xu Xin in the treatment of blood withered menstrual closure combined with obstruction in the abdomen.Professor Xu Xin believes that premature ovarian failure belongs to the category of blood withered menstrual closure in TCM,the etiology of which can be seen in essence and blood depletion and emotional anomalies;the mechanism of the disease is closely related to the dysfunction of visceral organs,and the source of qi and blood is not available,and the lack of essence and blood of the Chong Ren cystic uterus.Therefore,the treatment should be based on the basic rules of tonifying essence,qi and blood,adjusting the viscera and organs,and promoting blood circulation,and regulating menstruation.If combined with the obstruction in the abdomen,the patients'syndrome of blood stasis will be highlighted,and it is necessary to pay attention to the choice of drugs for removing blood stasis at the same time of applying the basic treatment,so as to support the healthy qi of the disease without leaving blood stasis,eliminating the obstruction in the abdomen without harming the healthy qi of the disease,and regulating the qi and blood to balance yin and yang,in order to obtain a significant therapeutic effect.

Objective:To discuss their effects of PLA(polylactic acid)/PTMC(polytrimethylene carbonate)and PLA/PTMC-calcium phosphate[Ca3(PO4)2]composite porous scaffolds prepared by 3D printing technology on bone marrow mesenchymal stem cells(BMSCs)of the rabbits,and to clarify their application values in bone defect repairment.Methods:After mixing the materials,PLA/PTMC and PLA/PTMC-Ca3(PO4)2 filaments were prepared by desktop filament extruder.The scaffolds were designed by CATIA V5-6R2019 modeling software and fabricated using CreatBot F430 3D printer.The chemical structure of the PLA/PTMC-Ca3(PO4)2 scaffold was detected by infrared spectroscopy.In vitro degradation experiments were used to detect the degradation weight loss rates and pH values of the two scaffolds.A contact angle measuring instrument was used to detect the hydrophilicities of the two scaffolds.The BMSCs were extracted from three newborn New Zealand white rabbits(2-5-day-old);CCK-8 method was used to detect the proliferation activities of the cells co-cultured with two scaffolds,and Alizarin red staining was used to observe the osteogenic differentiation of the cells co-cultured with two scaffolds.Results:Infrared spectroscopy confirmed the successful preparation of composite scaffolds containing PLA,PTMC,and β-Ca3(PO4)2.During degradation for 6-14 weeks,compared with PLA/PTMC scaffold,the degradation rates of the PLA/PTMC-Ca3(PO4)2 scaffold in lipase solution and phosphate-buffered saline(PBS)were significantly increased(P<0.05 or P<0.01).During degradation for 8-14 weeks,compared with PLA/PTMC scaffold,the pH value of the PLA/PTMC-Ca3(PO4)2scaffold in lipase solution was significantly increased(P<0.01).Compared with PLA/PTMC scaffold,the contact angle of the PLA/PTMC-Ca3(PO4)2 scaffold was significantly decreased(P<0.01).On days 5 and 7 of cell co-culture,compared with PLA/PTMC scaffold,the proliferation activity of the cells co-cultured with PLA/PTMC-Ca3(PO4)2 scaffold was significantly increased(P<0.05 or P<0.01).After 21 d of co-culture,both scaffolds overlapped with BMSCs and locally formed calcified nodules,which were stained orange by Alizarin red.Compared with PLA/PTMC scaffold,the number of mineralized calcium nodules in the cells co-cultured with PLA/PTMC-Ca3(PO4)2 scaffold was increased,with greater density and deeper color.Conclusion:The PLA/PTMC-Ca3(PO4)2 composite porous scaffolds containing PLA,PTMC,and β-Ca3(PO4)2 are successfully prepared by 3D printing technology.These scaffolds exhibit good degradation properties and show advantages in biocompatibility,hydrophilicity,and osteogenic induction;they are excellent materials for the bone defect repairment.

Objective To compare the efficacy of percutaneous double external fixators (EF) and EF combined with volar locking plate (VLP) in the treatment of AO C1,C2 and C3 type distal radius fracture (DRF). Methods The data of 108 patients with AO C-type DRF from 2019 to 2022 were reviewed. Fifty-one patients were treated with double EF (a no-bridging cemented-pin frame and a conventional wrist-bridging EF) and 57 patients were treated with EF (a conventional wrist-bridging EF) combined with VLP. The imaging parameters (palmar tilt,radial inclination,radial height,ulnar variance,etc.),wrist motion and grip strength were measured. Wrist pain intensity was evaluated by visual analogue scale (VAS). The whole function of the upper limb was assessed by disability of arm shoulder and hand scale (DASH),the wrist function was evaluated by Mayo wrist score (MWS),and the patient satisfaction was evaluated by short assessment of patient satisfaction (SAPS). The incidence of complications was evaluated according to the patient's chief complaint and the surgeon's comprehensive judgement. Results There were no significant differences in age,gender,injury cause,AO types or operation time between the 2 groups (all P>0.05). The time from injury to operation,intraoperative blood loss and hospital stay in the double EF group were superior to those in the EF combined with VLP group (all P<0.001). The patients were followed up for 24 to 33 months. There were no significant differences in palmar tilt,radial inclination,radial height or ulnar variance at the last follow-up (all P>0.05);the VAS score (P=0.025) and SAPS score (P=0.015) in the double EF group were significantly better than those in the EF combined with VLP group. There were no significant differences in the range of motion (flexion,extension,radial deviation,ulnar deviation,pronation or supination),grip strength,MWS or DASH scores between the 2 groups (all P>0.05). The overall complication rate of the double EF group was 13.73％ (7/51),which was lower than that of the EF combined with VLP group (28.07％) (16/57) (P<0.05). Conclusion Percutaneous double EF is easy to operate and relatively safe,with few complications and satisfactory follow-up results. It can be a treatment option for OA C-type DRF.

Objective:To investigate the safety, feasibility and accuracy of esophageal sponge cytology in esophageal carcinoma screening in high-incidence districts.Methods:Opportunistic screening for esophageal carcinoma was conducted on individuals aged 40-75 years with high-risk factors for esophageal carcinoma and visited out-patient clinic in Lianshui People's Hospital from May 2021 to June 2022. A new esophageal cell collector independently developed in China was used for esophageal sponge cytology sampling followed by cytopathological analysis. Atypical squamous cells or more severe lesions were defined as positive esophageal sponge cytology. Then gastroscopy was performed, and all suspicious areas under the endoscopy were biopsied for histopathological examination. Gastroscopy, biopsy histopathology and esophageal sponge cytology were conducted blindly in pairs. Outcome measures included adverse reactions during sampling, subject tolerability (using a visual simulation score), sampling quality, and diagnostic efficacy of esophageal sponge cytology using gastroscopy plus biopsy histopathology as the gold standard.Results:A total of 1 590 patients completed the screening program. During esophageal sponge cytology sampling, no serious adverse events were observed, and the adverse reactions were mainly manifested as vomiting during sampling [0.31% (5/1 590)] and sore throat after sampling [2.45% (39/1 590)], all of which resolved spontaneously without further medical intervention. The majority of subjects [98.62% (1 568/1 590)] reported good tolerance during the procedure. After sampling, 1 526 (95.97%) subjects had completely expanded sponge material, meeting the standard of good sampling quality. The scanning analysis of the digital pathology system showed that the number of sampled cells in 1 590 subjects ranged (2.01-4.00)×10 6, with a median of 3.48×10 6 cells, which could meet the requirements for interpreting cytological results. Using the positive esophageal sponge cytology for the diagnosis of esophageal carcinoma including high-grade intraepithelial neoplasia, esophageal squamous cell carcinoma and adenocarcinoma of esophagogastric junction, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 98.57% (69/70), 91.51% (1 391/1 520), 34.85% (69/198), 99.93% (1 391/1 392), and 91.82% (1 460/1 590), respectively. Conclusion:Esophageal sponge cytology presents promising diagnostic efficacy for esophageal carcinoma screening, offering a simple, safe, convenient, and effective approach in high-incidence esophageal carcinoma regions.

OBJECTIVE: To explore the prognostic value of early multiple detection indicators in combination with sequential organ failure assessment (SOFA) in sepsis patients. METHODS: A retrospective analysis was conducted. Patients with sepsis admitted to the department of critical care medicine of Huanggang Central Hospital of Yangtze University from May 2020 to May 2022 were selected as the research subjects. Coagulation indicators, inflammatory factors, blood routine, liver and kidney function, and blood gas analysis were collected at admission. Organ dysfunction was assessed based on the SOFA score within 24 hours after admission. Patients were divided into a survival group and a death group according to the outcome of 28 days in ICU. Differences in the above indicators between the two groups were compared. Multifactorial Logistic regression analysis was used to analyze prognostic factors of 28-day mortality in sepsis patients. Receiver operator characteristic curve (ROC curve) was drawn to analyze the predictive performance of various indicators, the SOFA score, and the combine model for the 28-day outcome in patients with sepsis. RESULTS: A total of 101 patients with sepsis were enrolled, 56 patients survived and 45 patients died. Compared to the survival group, patients in the death group were older, the proportion of patients with septic shock was larger, the SOFA score, and the proportion of pulmonary infection were higher, the prothrombin time (PT) and activated partial thromboplastin time (APTT) were significantly prolonged, the prothrombin activity (PTA) was significantly shortened, and antithrombin (AT) was significantly decreased, the levels of hypersensitivity C-reactive protein (hs-CRP), blood urea nitrogen (BUN), total bilirubin (TBil), and lactic acid (Lac) were significantly increased, while the platelet count (PLT) was significantly decreased. Multifactorial Logistic regression analysis showed that pulmonary infection [odds ratio (OR) = 0.010, 95% confidence interval (95%CI) was 0.001-0.164, P = 0.001], AT (OR = 0.944, 95%CI was 0.910-0.978, P = 0.002), hs-CRP (OR = 1.008, 95%CI was 1.001-1.015, P = 0.017), Lac (OR = 1.619, 95%CI was 1.195-2.193, P = 0.002), and SOFA score (OR = 1.363, 95%CI was 1.076-1.727, P = 0.010) were independent prognostic factors for 28-day mortality in patients. A combined model was constructed using pulmonary infection, AT, hs-CRP, Lac, and SOFA score. ROC curve analysis showed that the area under the ROC curve (AUC) for the combine model in predicting sepsis prognosis was 0.936 (95%CI was 0.869-0.975, P < 0.001), which was higher in value compared to single indicators (AUC of AT, hs-CRP, Lac, and SOFA score were 0.775, 0.666, 0.802, 0.796, respectively, all P < 0.05). CONCLUSIONS The predictive ability of the SOFA score for sepsis patient outcomes is limited. The combine model combining infection site, AT, hs-CRP, and Lac shows better predictive ability.
Humans ; Organ Dysfunction Scores ; Retrospective Studies ; C-Reactive Protein ; ROC Curve ; Sepsis/metabolism* ; Prognosis ; Anticoagulants ; Antithrombin III ; Intensive Care Units